Stop-Loss Attachment Point Calculator
Stop-Loss Attachment Point Calculator
Calculate recommended specific and aggregate stop-loss attachment points for your self-funded plan based on employee count, claims experience, and risk tolerance.
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Minimum 25 for self-funded stop-loss
Market median: ~$450–$550 PEPM for self-funded plans (2025)
Frequently Asked Questions
What is a specific stop-loss deductible?
The specific stop-loss deductible (also called the specific attachment point or SIR — self-insured retention) is the dollar threshold per individual claimant above which the stop-loss carrier pays claims. For example, with a $100,000 specific deductible, the employer pays the first $100,000 of any individual's claims in a plan year, and the stop-loss carrier covers amounts above that.
What is aggregate stop-loss insurance?
Aggregate stop-loss insurance caps the employer's total annual claims liability across all plan members. It is typically set at 115–125% of expected annual claims. If total plan claims exceed the aggregate attachment point, the stop-loss carrier pays the excess. Aggregate coverage protects against a bad claims year where multiple members have high-cost claims simultaneously.
How is the specific deductible calculated?
The specific deductible is typically set at 3–5× the average monthly claims PEPM (per employee per month), adjusted for group size and risk tolerance. Larger groups can absorb higher deductibles because their larger member pool provides more statistical predictability. This calculator uses published carrier guidelines and actuarial rules of thumb to recommend a range.
What does stop-loss insurance cost?
Stop-loss premiums vary by group size, attachment point, industry, claims history, contract basis, and carrier underwriting. This calculator provides educational estimate ranges based on your inputs; a broker or carrier quote is required to understand the actual premium and coverage terms.
What is the corridor in aggregate stop-loss?
The aggregate corridor is the gap between expected claims and the aggregate attachment point — typically 115–125% of expected claims. A 120% aggregate means the employer is responsible for the first 20% above expected claims before aggregate coverage kicks in. Conservative plans use 115%; aggressive plans may use 125% or higher to reduce premiums.